%0 Journal Article %A Estrid Høgdall %A Claus Høgdall %A Thao Vo %A Wei Zhou %A Lingkang Huang %A Matthew Marton %A Stephen M Keefe %A Michael Busch-Sørensen %A Sarah M. Sørensen %A Jeanette Georgsen %A Else Mejlgaard %A Lotte Nedergaard %A Torben Steiniche %T Impact of PD-L1 and T-cell inflamed gene expression profile on survival in advanced ovarian cancer %D 2020 %R 10.1136/ijgc-2019-001109 %J International Journal of Gynecologic Cancer %P ijgc-2019-001109 %X Objective Programmed death ligand 1 (PD-L1) expression affects tumor evasion of immune surveillance. The prognostic value and relationship of PD-L1 expression to T-cell–inflamed immune signatures in ovarian cancer are unclear. The purpose of this study is to evaluate the impact of PD-L1 on overall survival and its correlation with an immune-mediated gene expression profile in patients with advanced ovarian cancer.Methods PD-L1 expression in tumor and immune cells was assessed by immunohistochemistry, and PD-L1–positive expression was defined as a combined positive score ≥1; a T-cell–inflamed gene expression profile containing interferon γ response genes was evaluated using extracted RNA from surgical samples. Associations between PD-L1 expression, gene expression profile status, and overall survival were analyzed using the Kaplan-Meier method, log-rank test, and multivariate Cox proportional hazards regression models.Results A total of 376 patients with advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer treated by cytoreductive surgery and platinum-based therapy were included. PD-L1–positive expression was observed in 50.5% of patients and associated with more advanced stage (p=0.047), more aggressive histologic subtype (p=0.001), and platinum sensitivity defined by increasing treatment-free interval from first platinum-based chemotherapy to next systemic treatment (p=0.027). PD-L1–positive expression was associated with longer overall survival in multivariate analyses (adjusted HR 0.72, 95% CI 0.56 to 0.93). In subgroup analyses, this association was most pronounced in patients with partially platinum-sensitive disease (treatment-free interval ≥6 to <12 months). T-cell–inflamed gene expression profile status correlated with PD-L1 expression (Spearman, ρ=0.712) but was not an independent predictor of overall survival.Conclusion PD-L1 expression is associated with longer overall survival among advanced ovarian cancer patients. PD-L1 expression may be an independent prognostic biomarker. %U https://ijgc.bmj.com/content/ijgc/early/2020/06/26/ijgc-2019-001109.full.pdf